A population-based analysis of predictors of penile surgical intervention among inpatients with acute priapism.

While consensus exists regarding risk factors for priapism, predictors of operative intervention are less well established. We assessed patient and hospital-level predictors associated with penile surgical intervention (PSI) for patients admitted with acute priapism, as well as length of stay (LOS) and total hospital charges using the National Inpatient Sample (2010-2015). Inpatients with acute priapism were stratified by PSI, defined as penile shunts, incisions, and placement of penile prostheses, exclusive of irrigation procedures.

Exploring the Use of Exchange Transfusion in the Surgical Management of Priapism in Sickle Cell Disease: A Population-Based Analysis.

Introduction: Priapism is a urologic emergency that may require surgical intervention in cases refractory to supportive care. Exchange transfusion (ET) has been previously used to manage sickle cell disease (SCD), including in priapism; however, its utilization in the context of surgical intervention has not been well-established.

Aim: To explore the utilization of ET, as well as other patient and hospital-level factors, associated with surgical intervention for SCD-induced priapism METHODS: Using the National Inpatient Sample (2010-2015), males diagnosed with SCD and priapism were stratified by need for surgical intervention.

The impact of SARS-CoV-2 and COVID-19 on male reproduction and men's health.

Many couples initially deferred attempts at pregnancy or delayed fertility care due to concerns about coronavirus disease 2019 (COVID-19). One significant fear during the COVID-19 pandemic was the possibility of sexual transmission. Many couples have since resumed fertility care while accepting the various uncertainties associated with severe acute respiratory syndrome coronavirus 2, including the evolving knowledge related to male reproductive health.

No evidence of severe acute respiratory syndrome-coronavirus 2 in semen of males recovering from coronavirus disease 2019.

Objective: To describe detection of severe acute respiratory syndrome (SARS)-coronavirus 2 (CoV-2) in seminal fluid of patients recovering from coronavirus disease 2019 (COVID-19) and to describe the expression profile of angiotensin-converting enzyme 2 (ACE2) and Transmembrane Serine Protease 2 (TMPRSS2) within the testicle.

Design: Observational, cross-sectional study.

Setting: Tertiary referral center.

Empirical medical therapy for idiopathic male infertility.

Objective: To determine if there has been a change in empirical medical therapy (EMT) practices since a 2010 American Urological Association survey reported that 25% of urologists treated infertile men who were pursuing a pregnancy with testosterone (T).

Design: Survey-based cohort study of AUA members.

Setting: Practice patterns were evaluated of urologists in academic and nonacademic hospital centers.

Widespread Transcriptional Scanning in the Testis Modulates Gene Evolution Rates.

The testis expresses the largest number of genes of any mammalian organ, a finding that has long puzzled molecular biologists. Our single-cell transcriptomic data of human and mouse spermatogenesis provide evidence that this widespread transcription maintains DNA sequence integrity in the male germline by correcting DNA damage through a mechanism we term transcriptional scanning. We find that genes expressed during spermatogenesis display lower mutation rates on the transcribed strand and have low diversity in the population.

Fertility Preservation in Male to Female Transgender Patients.

Gender dysphoria, or the incongruence between gender identification and sex assigned at birth with associated discomfort or distress, manifests in transgender patients, whose multifaceted care includes puberty suppression, cross-sex hormonal therapy, and gender-affirming surgery. Discussion of fertility preservation (FP) is paramount because many treatments compromise future fertility, and although transgender patients demonstrate desire for children, use of FP remains low for a plethora of reasons. In transgender women, established FP options include ejaculated sperm cryopreservation, electroejaculation, or testicular sperm extraction.

Quantitative Proton Spectroscopy of the Testes at 3 T: Toward a Noninvasive Biomarker of Spermatogenesis.

Objectives: The aim of this study was to compare testicular metabolite concentrations between fertile control subjects and infertile men.

Materials And Methods: Single voxel proton magnetic resonance spectroscopy (H-MRS) was performed in the testes with and without water suppression at 3 T in 9 fertile control subjects and 9 infertile patients (8 with azoospermia and 1 with oligospermia). In controls only, the T1 and T2 values of water and metabolites were also measured.

Multicenter Investigation of the Micro-Organisms Involved in Penile Prosthesis Infection: An Analysis of the Efficacy of the AUA and EAU Guidelines for Penile Prosthesis Prophylaxis.

Introduction: Penile prosthesis infections remain challenging despite advancements in surgical technique, device improvements, and adoption of antibiotic prophylaxis guidelines.

Aim: To investigate penile prosthesis infection microbiology to consider which changes in practice could decrease infection rates, to evaluate current antibiotic prophylaxis guidelines, and to develop a proposed algorithm for penile prosthesis infections.

Methods: This retrospective institutional review board-exempt multi-institutional study from 25 centers reviewed intraoperative cultures obtained at explantation or Mulcahy salvage of infected three-piece inflatable penile prostheses (IPPs).

Trends in Testosterone Prescription and Public Health Concerns.

Testosterone supplementation therapy (TST) has become increasingly popular since the turn of the century. Most prescriptions in the U.S.

Testosterone Deficiency and the Prostate.

Male hormonal physiology plays an important role in the function and development of the prostate. Moreover, benign prostatic hyperplasia and prostate cancer, two common and bothersome conditions of the prostate, are also influenced by hormonal activity. This article reviews the existing data regarding these complex relationships.

A pilot study to determine penile oxygen saturation before and after vacuum therapy in patients with erectile dysfunction after radical prostatectomy.

Introduction: Provoked and spontaneous nocturnal erections are thought to play a role in maintenance of male sexual health through oxygenation of the corpus cavernosa. Conversely, hypoxia is thought to be an etiological factor in the pathogenesis of cavernosal fibrosis and long-term erectile dysfunction. It has been hypothesized that the early penile hypoxia after radical prostatectomy (RP) may lead to fibrosis and consequently a decrease in stretched penile length and long-term erectile dysfunction.

Long-term satisfaction and predictors of use of intracorporeal injections for post-prostatectomy erectile dysfunction.

Purpose: Intracorporeal injections have low use rates and high discontinuation rates. We examined factors associated with intracorporeal injection use, long-term satisfaction with intracorporeal injection and reasons for discontinuation in men treated with radical prostatectomy.

Materials And Methods: Between October 2000 and September 2003, 731 men who underwent open radical retropubic prostatectomy were enrolled in a prospective outcomes study.

Why treat the male in the era of assisted reproduction?

The concept of unilateral care of the female partner has gained momentum in the reproductive health community, especially with the advent of in vitro fertilization and intracytoplasmic sperm injection. Herein, the authors examine the existing evidence in support of evaluating and treating the male patient as part of the routine evaluation of the infertile couple. This evidence includes assessments of efficacy, cost-effectiveness, and safety, and-- when considered broadly--argues strongly against unilateral care.

Intracytoplasmic sperm injection (ICSI)--what are the risks?

In vitro fertilization used in combination with intracytoplasmic sperm injection allows otherwise sterile couples to become parents. Despite recent studies on the safety of these technologies, there is still only an incomplete picture of the risks associated with the usage of these assisted reproductive techniques to offspring. The risk of multiple gestations continues to be of major concern because of its association with low birth weight, preterm delivery, and increased perinatal mortality.

Safety of assisted reproduction, assessed by risk of abnormalities in children born after use of in vitro fertilization techniques.

Assisted reproductive technologies are increasingly used in the treatment of both male and female infertility. The techniques, including in vitro fertilization, with or without intracytoplasmic sperm injection as an adjunctive treatment, represent a tremendous step forward for infertile couples who previously had no treatment options. As we move towards the 30(th) anniversary of the birth of the first baby conceived by in vitro fertilization, questions about the safety of these procedures linger.

Testicular hypotrophy does not correlate with grade of adolescent varicocele.

Purpose: Testicular hypotrophy is the most widely accepted indication for correcting adolescent varicocele. Previous studies in adolescents have shown a relationship between increasing grade of varicocele and the likelihood of testicular hypotrophy. As this relationship has significant clinical implications, we studied the correlation between grade and testicular volume disproportion in our adolescent varicocele population.